Diverse diuretics regimens differentially enhance the antialbuminuric effect of renin-angiotensin blockers in patients with chronic kidney disease.

Abstract:

:The addition of spironolactone or hydrochlorothiazide enhances the antialbuminuric effect of renin-angiotensin blockers. However, comparative studies on the effect of different diuretics are lacking. We conducted a prospective randomized crossover study to compare the effects of spironolactone (25 mg/day), hydrochlorothiazide (50 mg/day) without/with amiloride (5 mg/day) on top of enalapril treatment in 21 patients with CKD stages 1-3 and a urinary albumin-to-creatinine ratio (UACR) over 300 mg/g. Treatment periods lasted 4 weeks. The UACR showed a significant reduction with the diuretics: spironolactone, -34% or hydrochlorothiazide without/with amiloride -42% or -56%, respectively. Reduction of the UACR was significantly greater with hydrochlorothiazide without/with amiloride when compared with spironolactone. The percentage of patients who achieved UACR reductions greater than 30% and 50% was greater with hydrochlorothiazide without/with amiloride (81% and 57%, and 81% and 66%, respectively) when compared with spironolactone alone (57% and 28%, respectively). Glomerular filtration rate (GFR), blood pressure, and body weight decreased with the three diuretic regimens. A significant correlation was found between the UACR reduction and GFR and blood pressure changes. Thus, diverse diuretic regimens differentially enhance albuminuria reduction, an effect likely associated with the degree of GFR reduction.

journal_name

Kidney Int

journal_title

Kidney international

authors

Morales E,Caro J,Gutierrez E,Sevillano A,Auñón P,Fernandez C,Praga M

doi

10.1038/ki.2015.249

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

1434-1441

issue

6

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)61054-7

journal_volume

88

pub_type

杂志文章
  • Enhanced posttransplant management of patients with diabetes improves patient outcomes.

    abstract::The survival of patients with diabetes mellitus in the general population has improved in recent years. Here we assessed whether similar trends have occurred in 1688 kidney recipients, including 413 with diabetes prior to transplant between 1996 and 2007. Compared to patients without diabetes, the 5-year mortality was...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.2014.70

    authors: Keddis MT,El Ters M,Rodrigo E,Dean P,Wohlfahrtova M,Kudva YC,Lorenz EC,Cosio FG

    更新日期:2014-09-01 00:00:00

  • Microalbuminuria three years after recovery from Escherichia coli O157 hemolytic uremic syndrome due to municipal water contamination.

    abstract:BACKGROUND:Knowledge of the long-term renal prognosis of diarrhea associated hemolytic uremic syndrome (HUS) is important for patient counseling and follow-up. However, estimates of long-term risk are highly variable, with previous studies not using a healthy control group. METHODS:A municipal water system in the smal...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1111/j.1523-1755.2005.00225.x

    authors: Garg AX,Clark WF,Salvadori M,Macnab J,Suri RS,Haynes RB,Matsell D,Walkerton Health Study Investigators.

    更新日期:2005-04-01 00:00:00

  • Alternate repetition of short fore- and backfiltrations reduces convective albumin loss.

    abstract::An effective therapeutic means to remove relatively large polypeptide uremic toxins seems to be a hemofiltration (HF) or hemodiafiltration (HDF) employing a larger-pore membrane, that is, a protein-permeable membrane. With either method, however, a significant amount of albumin will be lost into the ultrafiltrate or d...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.1996.333

    authors: Shinzato T,Miwa M,Nakai S,Takai I,Matsumoto Y,Morita H,Miyata T,Maeda K

    更新日期:1996-08-01 00:00:00

  • Subtotal nephrectomy impairs ischemia-induced angiogenesis and hindlimb re-perfusion in rats.

    abstract::Kidney disease is associated with increased cardiovascular morbidity, but underlying mechanisms are poorly understood. We tested the hypothesis that chronic renal insufficiency impairs angioadaptation in a rat model of hindlimb ischemia. Twenty male Sprague-Dawley rats (8 weeks old) underwent subtotal nephrectomy (5/6...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/sj.ki.5000448

    authors: Jacobi J,Porst M,Cordasic N,Namer B,Schmieder RE,Eckardt KU,Hilgers KF

    更新日期:2006-06-01 00:00:00

  • Costimulatory blockade molecules and B-cell-mediated immune response: current knowledge and perspectives.

    abstract::There is an urgent need for therapeutic agents that target humoral alloimmunity in solid organ transplantation. This includes sensitized patients with preformed donor-specific human leukocyte antigen antibodies and patients who develop de novo donor-specific antibodies, both of which are associated with acute and chro...

    journal_title:Kidney international

    pub_type: 杂志文章,评审

    doi:10.1016/j.kint.2018.10.028

    authors: Leibler C,Thiolat A,Elsner RA,El Karoui K,Samson C,Grimbert P

    更新日期:2019-04-01 00:00:00

  • Caveolin-1 in mesangial cells suppresses MAP kinase activation and cell proliferation induced by bFGF and PDGF.

    abstract:BACKGROUND:Caveolin is a principal component of caveolae and regulates signaling in caveolae. Mesangial cells contain many caveolae, and thus manipulation of caveolin-1 expression level might be useful to control mesangial cell proliferation, which is an important aggravating factor in many renal diseases. METHODS:In ...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1111/j.1523-1755.2004.00954.x

    authors: Fujita Y,Maruyama S,Kogo H,Matsuo S,Fujimoto T

    更新日期:2004-11-01 00:00:00

  • Changes in bone structure and the muscle-bone unit in children with chronic kidney disease.

    abstract::The impact of pediatric chronic kidney disease (CKD) on acquisition of volumetric bone mineral density (BMD) and cortical dimensions is lacking. To address this issue, we obtained tibia quantitative computed tomography scans from 103 patients aged 5-21 years with CKD (26 on dialysis) at baseline and 12 months later. G...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.2012.347

    authors: Tsampalieros A,Kalkwarf HJ,Wetzsteon RJ,Shults J,Zemel BS,Foster BJ,Foerster DL,Leonard MB

    更新日期:2013-03-01 00:00:00

  • Genomic and clinical profiling of a national nephrotic syndrome cohort advocates a precision medicine approach to disease management.

    abstract::Steroid Resistant Nephrotic Syndrome (SRNS) in children and young adults has differing etiologies with monogenic disease accounting for 2.9-30% in selected series. Using whole exome sequencing we sought to stratify a national population of children with SRNS into monogenic and non-monogenic forms, and further define t...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1016/j.kint.2016.10.013

    authors: Bierzynska A,McCarthy HJ,Soderquest K,Sen ES,Colby E,Ding WY,Nabhan MM,Kerecuk L,Hegde S,Hughes D,Marks S,Feather S,Jones C,Webb NJ,Ognjanovic M,Christian M,Gilbert RD,Sinha MD,Lord GM,Simpson M,Koziell AB,Welsh

    更新日期:2017-04-01 00:00:00

  • Testing the homocysteine hypothesis in end-stage renal disease: Problems and a possible solution.

    abstract::The homocysteine hypothesis states that circulating homocysteine is a vascular toxin in concentrations that occur in the general population and in renal failure. This hypothesis is currently being tested in the Kidney and End State Renal Disease Study (HOST), but data have emerged since the HOST began that suggest its...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/sj.ki.5000279

    authors: Hoffer LJ

    更新日期:2006-05-01 00:00:00

  • Influence of systemically applied angiotensin II on the microcirculation of glomerular capillaries in the rat.

    abstract::The effect of intravenous infusion of angiotensin II on microvascular parameters of the renal microcirculation of rats was studied. With the aid of fluorescence microscopy and a high sensitivity video system we observed the passage of fluorescence-labeled erythrocytes through single glomerular capillaries on the surfa...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.1985.4

    authors: Zimmerhackl B,Parekh N,Kücherer H,Steinhausen M

    更新日期:1985-01-01 00:00:00

  • Remodeling of renal interstitial and tubular lesions in pancreas transplant recipients.

    abstract::Tubular atrophy and interstitial fibrosis, important in progression of renal diseases, including diabetic (D) and cyclosporine-induced (CSA) nephropathy, have been considered irreversible. Normoglycemia for 10 years following pancreas transplantation alone (PTA) reversed D glomerulopathy lesions. This study quantified...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/sj.ki.5000153

    authors: Fioretto P,Sutherland DE,Najafian B,Mauer M

    更新日期:2006-03-01 00:00:00

  • Evaluation of the micropuncture determination of single nephron filtration fraction.

    abstract::Spontaneous and aspirated blood samples were collected from the welling points of surface efferent arterioles in the rat kidney. The amount of tubular reabsorbate in each sample was calculated from measurements of the inulin concentration in the sample and systemic arterial plasma. Both spontaneous and aspirated sampl...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.1984.44

    authors: Jensen PK,Blaehr H,Steven K

    更新日期:1984-03-01 00:00:00

  • Molecular cloning of KS, a novel rat gene expressed exclusively in the kidney.

    abstract:BACKGROUND:We aimed to identify genes with kidney specific, developmentally regulated expression. Here we report the cDNA sequence and expression pattern of KS, a novel kidney-specific rat gene. METHODS:A partial cDNA was identified by differential display polymerase chain reaction (PCR) of a renal cell fraction enric...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1046/j.1523-1755.1998.00143.x

    authors: Hilgers KF,Nagaraj SK,Karginova EA,Kazakova IG,Chevalier RL,Carey RM,Pentz ES,Gomez RA

    更新日期:1998-11-01 00:00:00

  • Immunoreactive and bioactive luteinizing hormone in pubertal patients with chronic renal failure. Cooperative Study Group on Pubertal Development in Chronic Renal Failure.

    abstract::Disturbed pulsatile LH secretion has been suggested to play a role in the etiology of delayed puberty and disturbed reproductive function in chronic renal failure (CRF), but interpretation of gonadotropin secretion from plasma concentration measurements is confounded by alterations in hormone metabolic clearance. To s...

    journal_title:Kidney international

    pub_type: 杂志文章,多中心研究

    doi:10.1038/ki.1994.191

    authors: Schaefer F,Veldhuis JD,Robertson WR,Dunger D,Schärer K

    更新日期:1994-05-01 00:00:00

  • The severity of acute kidney injury predicts progression to chronic kidney disease.

    abstract::Acute kidney injury (AKI) is associated with progression to advanced chronic kidney disease (CKD). We tested whether patients who survive AKI and are at higher risk for CKD progression can be identified during their hospital admission, thus providing opportunities to intervene. This was assessed in patients in the Dep...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.2011.42

    authors: Chawla LS,Amdur RL,Amodeo S,Kimmel PL,Palant CE

    更新日期:2011-06-01 00:00:00

  • Cysteamine therapy delays the progression of nephropathic cystinosis in late adolescents and adults.

    abstract::Nephropathic cystinosis is a multisystem autosomal recessive disease caused by cystine accumulation, which is usually treated by oral cysteamine. In order to determine long-term effects of this therapy, we enrolled 86 adult patients (mean age 26.7 years) diagnosed with nephropathic cystinosis, 75 of whom received cyst...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.2011.277

    authors: Brodin-Sartorius A,Tête MJ,Niaudet P,Antignac C,Guest G,Ottolenghi C,Charbit M,Moyse D,Legendre C,Lesavre P,Cochat P,Servais A

    更新日期:2012-01-01 00:00:00

  • The histone deacetylase, SIRT1, contributes to the resistance of young mice to ischemia/reperfusion-induced acute kidney injury.

    abstract::Acute kidney injury (AKI) is a critical condition with a mortality rate as high as 50% and significantly contributes to the burden of end-stage renal disease (ESRD) requiring renal replacement therapy. The incidence and prognosis of AKI have been shown to vary with patient age, with younger individuals being more resi...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.2012.394

    authors: Fan H,Yang HC,You L,Wang YY,He WJ,Hao CM

    更新日期:2013-03-01 00:00:00

  • Hemodialysis leukopenia and complement function with different dialyzers.

    abstract::The relationship between leukopenia and the complement system during hemodialysis was re-examined by studying not only the in vivo effects of four different dialyzer membranes (cellulose hydrate, cuprophan, cellulose acetate, and polyacrilonitrile) on leukocyte counts and complement levels, but especially by investiga...

    journal_title:Kidney international

    pub_type: 临床试验,杂志文章

    doi:10.1038/ki.1983.227

    authors: Amadori A,Candi P,Sasdelli M,Massai G,Favilla S,Passaleva A,Ricci M

    更新日期:1983-12-01 00:00:00

  • Influence of continuous ambulatory peritoneal dialysis on the anemia of endstage renal disease.

    abstract::To evaluate the effect of continuous ambulatory peritoneal dialysis (CAPD) on the anemia of endstage renal disease, serial measurements of red cell mass and other hematological parameters were performed in 34 patients. Twenty-five patients were measured at the start and at 6 months (group 1), 13 at the start, at 6 and...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.1983.88

    authors: De Paepe MB,Schelstraete KH,Ringoir SM,Lameire NH

    更新日期:1983-05-01 00:00:00

  • Dysfunction of epithelial sodium transport: from human to mouse.

    abstract::The highly amiloride-sensitive epithelial sodium channel (ENaC) is an apical membrane constituent of cells of many salt-absorbing epithelia. In the kidney, the functional relevance of ENaC expression has been well established. ENaC mediates the aldosterone-dependent sodium reabsorption in the distal nephron and is inv...

    journal_title:Kidney international

    pub_type: 杂志文章,评审

    doi:10.1046/j.1523-1755.2000.00968.x

    authors: Bonny O,Hummler E

    更新日期:2000-04-01 00:00:00

  • Improvement of growth and food utilization by human recombinant growth hormone in uremia.

    abstract::We compared growth rate, food conversion ratio and morphology of the growth zone in female Sprague-Dawley rats with subtotal nephrectomy or sham operation. Both groups were either given vehicle or 1.4 IU/day recombinant human growth hormone (GH) by s.c. osmotic minipump, or 2.5 IU twice daily intraperitoneally for 14 ...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.1988.7

    authors: Mehls O,Ritz E,Hunziker EB,Eggli P,Heinrich U,Zapf J

    更新日期:1988-01-01 00:00:00

  • Treatment of hepatitis B virus-associated membranous nephropathy with recombinant alpha-interferon.

    abstract::An open, randomized trial study on the therapeutic effect of recombinant alpha-interferon (IFN alpha) in 40 patients with hepatitis B virus membranous nephropathy (HBVMN) was conducted. All were pathologically proven to have HBVMN which showed no response to corticosteroid treatment represented by persistent heavy pro...

    journal_title:Kidney international

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1038/ki.1995.27

    authors: Lin CY

    更新日期:1995-01-01 00:00:00

  • The hypoxia-inducible factor-1 DNA recognition site is cAMP-responsive.

    abstract::The hypoxia-inducible factor-1 (HIF-1) was first described as a DNA binding activity that specifically recognizes an 8 bp hypoxia response element (HRE) known to be essential for oxygen-regulated erythropoietin gene expression. In electrophoretic mobility shift assays (EMSAs) HIF-1 DNA binding activity is only detecta...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.1997.80

    authors: Kvietikova I,Wenger RH,Marti HH,Gassmann M

    更新日期:1997-02-01 00:00:00

  • COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain.

    abstract::Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis therapy than in the g...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1016/j.kint.2020.04.031

    authors: Goicoechea M,Sánchez Cámara LA,Macías N,Muñoz de Morales A,Rojas ÁG,Bascuñana A,Arroyo D,Vega A,Abad S,Verde E,García Prieto AM,Verdalles Ú,Barbieri D,Delgado AF,Carbayo J,Mijaylova A,Acosta A,Melero R,Tejedor A,Ben

    更新日期:2020-07-01 00:00:00

  • ACE inhibition limits chronic injury of kidney transplant even with treatment started when lesions are established.

    abstract:BACKGROUND:Inhibition of the renin-angiotensin system (RAS) prevents development of chronic allograft dysfunction in experimental animals. Whether this therapeutic approach is effective even if started when signs of allograft nephropathy are already manifested has not been investigated. METHODS:To address this issue, ...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1046/j.1523-1755.2003.00318.x

    authors: Noris M,Mister M,Pezzotta A,Azzollini N,Cassis P,Benigni A,Gagliardini E,Perico N,Remuzzi G

    更新日期:2003-12-01 00:00:00

  • Cardiac hypertrophy and remodeling in relation to ACE and angiotensinogen genes genotypes in Chinese dialysis patients.

    abstract:BACKGROUND:Genetic polymorphisms of the angiotensinogen (AGT) and angiotensin-converting enzyme (ACE) genes are associated with increased risk of hypertension and left ventricular hypertrophy (LVH) in hypertensive subjects. However, the extent to which these polymorphisms are related to LVH and remodeling in dialysis p...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1046/j.1523-1755.2003.00933.x

    authors: Wang AY,Chan JC,Wang M,Poon E,Lui SF,Li PK,Sanderson J

    更新日期:2003-05-01 00:00:00

  • Serum adiponectin predicts all-cause mortality and end stage renal disease in patients with type I diabetes and diabetic nephropathy.

    abstract::Adiponectin levels are increased in patients with type I diabetes especially in the presence of microangiopathy. Here we determined the predictive value of serum adiponectin levels and 8 adiponectin gene polymorphisms for mortality, cardiovascular events and end-stage renal disease in type I diabetic patients. This pr...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1038/ki.2008.201

    authors: Jorsal A,Tarnow L,Frystyk J,Lajer M,Flyvbjerg A,Parving HH,Vionnet N,Rossing P

    更新日期:2008-09-01 00:00:00

  • Differential expression of Cux-1 and p21 in polycystic kidneys from Pkd1 null and cpk mice.

    abstract:BACKGROUND:Cux-1 is a murine homeodomain protein that functions as a cell cycle-dependent transcriptional repressor in proliferating cells. Targets of Cux-1 repression include the cyclin kinase inhibitors p21 and p27. In the kidney, Cux-1 is spatially and temporally regulated, and ectopic expression of Cux-1 in transge...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1111/j.1523-1755.2005.67099.x

    authors: Sharma M,Brantley JG,Alcalay NI,Zhou J,Heystek E,Maser RL,Vanden Heuvel GB

    更新日期:2005-02-01 00:00:00

  • Thrombomodulin ameliorates transforming growth factor-β1-mediated chronic kidney disease via the G-protein coupled receptor 15/Akt signal pathway.

    abstract::Kidney fibrosis is the common consequence of chronic kidney diseases that inexorably progresses to end-stage kidney disease with organ failure treatable only with replacement therapy. Since transforming growth factor-β1 is the main player in the pathogenesis of kidney fibrosis, we posed the hypothesis that recombinant...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1016/j.kint.2020.05.041

    authors: Takeshita A,Yasuma T,Nishihama K,D'Alessandro-Gabazza CN,Toda M,Totoki T,Okano Y,Uchida A,Inoue R,Qin L,Wang S,D'Alessandro VF,Kobayashi T,Takei Y,Mizoguchi A,Yano Y,Gabazza EC

    更新日期:2020-11-01 00:00:00

  • Mortality prediction in stable hemodialysis patients is refined by YKL-40, a 40-kDa glycoprotein associated with inflammation.

    abstract::Chronic inflammation contributes to increased mortality in hemodialysis (HD) patients. YKL-40 is a novel marker of inflammation, tissue remodeling, and highly expressed in macrophages inside vascular lesions. Elevated levels of YKL-40 have been reported for HD patients but how it integrates into the proinflammatory me...

    journal_title:Kidney international

    pub_type: 杂志文章

    doi:10.1016/j.kint.2017.07.010

    authors: Lorenz G,Schmalenberg M,Kemmner S,Haller B,Steubl D,Pham D,Schreiegg A,Bachmann Q,Schmidt A,Haderer S,Huber M,Angermann S,Günthner R,Braunisch M,Hauser C,Reichelt AL,Matschkal J,Suttmann Y,Moog P,Stock K,Küchle C

    更新日期:2018-01-01 00:00:00